Network meta-analysis of the effectiveness of TCM external treatment in the treatment of mycoplasmal pneumonia

Objective: To compare the efficacy and safety of different TCM external treatment combined with azithromycin in the treatment of Mycoplasma pneumoniae pneumonia. Methods: The keywords and free words were combined to search the literatures of clinical randomized or quasi-randomized controlled trials on the effects of TCM external treatment combined with azithromycin in the treatment of children with MPP in CNKI, VIP, CBM, Wan Fang Date, PubMed, Sciencedirect and Google Academic Database. The search time limit is from August 2019. After two independent reviewers selected the literature, extracted data and literature quality evaluation according to the inclusion and exclusion criteria, the ADDI software, RevMan5.3 and stata14.0 software were used for mesh meta-analysis. Results: A total of 18 randomized controlled literatures were included, involving 1536 children with MPP, 6 Chinese medicine external treatment methods (ultra-short wave, acupoint application, cupping, enema, Chinese medicine patch, massage). The results of mesh meta-analysis showed that treatment In terms of MPP efficiency, ultrashort wave, acupoint application, cupping, enema, Chinese medicine patch, massage combined with azithromycin treatment is more effective than azithromycin alone, and the probability distribution shows that the Chinese medicine patch combined with azithromycin treatment is the best solution (P= 0.34). In the reduction of adverse reactions, because the ultrashort wave and traditional Chinese medicine patch literature did not mention the non-performing rate, this study only analyzed the other four external treatment methods, acupoint application, cupping, enema, massage combined with azithromycin is better than single With azithromycin, the probability distribution showed that the probability of massage combined with azithromycin was the best (P=0.67). Conclusion: In terms of efficiency and reduction of adverse reactions, each Chinese medicine external treatment combined with azithromycin has an advantage over single azithromycin. Probability distribution shows that in the treatment of MPP efficiency, Chinese medicine patch + Achi > ultrashort wave + AZM > enema + AZM > cupping + AZM > massage + Aqi, Chinese medicine patch + azithromycin program is the optimal program;In terms of reducing adverse reactions, massage + AZM > enema + AZM > acupressure application + AZM > cupping +AZM.

Conversing Rate from Morphine to Continuous Infusion of Fentanyl in Patients Suffering Cancer Pain

Objective： To investigate the proper conversing rate from morphine to continuous infusion of fentanyl in patients suffering cancer pain. Methods： A retrospective study was carried on in 20 patients with cancer pain in Shizuoka Cancer Center from Sep. 2002 to Nov. 2003. Pain intensity, adverse reactions, and satisfaction index of patients were evaluated. Results： The pain intensity was stable in 17 patients indicating good pain-control within 1 week after conversion and unstable in 3 patients after conversion suggesting poor pain-control. Fentanyl injection could alleviate side effects and increase the satisfaction index of patients. Conclusion： The equipotent ratio for conversion of low dose morphine to fentanyl injection was established as 72：1, and for non low dose morphine a ratio less than 72：1 was proposed to get stable pain-relieving effect. But the equipotent ratio for conversion of morphine to continuous infusion of fentanyl could not be determined. We must consider the morphine dose before the confirmation of the conversing rate.

EXPERIMENTAL STUDY ON THE EFFECT OF ACUPUNCTURE ON TROPISM-DISTRIBUTION OF TETRAMETHYLPYRAZINE AND THE CONTENT OF cAMP IN ARTHRITIS RATS

Objective: To verify two hypotheses: 1) Acupuncture can increase the re-distribution of tetramethylpyrazine (ligustrazine) hydrochloride (TMPH) to the target organs in adjuvant arthritic rats. 2) Cyclic Adenosine-3’, 5’-monophosphate (cAMP) is one of the guidance cues involved in this event. Methods: A total of 40 Wistar rats were randomized into blank control (BC), model (MO), medication (ME), Acupuncture (Acu) and Acu+ME groups, with 8 cases in each group. Arthritis model was established by subcutaneous injection of complete Freund’s adjuvant (0.1 mL) into the rat’s foot pad. Electroacupuncture (15 Hz, 0.2-0.3V) was applied to bilateral “Daling”(大陵PC 7), “Taichong” (太冲LR 3) and “Xiguan” (膝关LR 7) for 20 min, and the contents of TMPH in the heart, liver, kidney and the foot (affected focus) tissues and the contents of cAMP in the heart and liver tissues were determined with high performance liquid chromatography and radioimmunoassay techniques respectively. Results: Compared with medication group, the TMPH contents in the heart, liver, kidney and the affected foot tissues in Acu-ME group was obviously higher (P<0.05, P<0.01). In comparison with ME and Acu groups, the cAMP contents in the heart and liver in Acu+ME group was also significantly higher (P<0.05, P<0.01). No significant differences were found between ME and Acu+ME groups in TMPH content of kidney and between Acu+ME and BC groups in cAMP contents in both liver and heart tissues. Conclusion: Acupuncture may promote the target-tropism distribution of ligustrazine, and cAMP may play an important role in it.

On the treatment of Tourette's syndrome in children from the perspective of "reconciling Shaoyang"

Tourette's syndrome is a syndrome characterized by involuntary,recurrent and aimless muscle motor twitching or vocal twitching in one or more locations,which seriously affects the learning and life of children and their families.Professor The author believes that the key to the pathogenesis of children with tourette's syndrome is"the disadvantageous of cardinal Shaoyang,viscera imbalance of Yin and Yang",proposed from the"reconciling Shaoyang"to treat the disease,and use of radix bupleuri class formula add and subtract cleaning the Shaoyang heat,harmonize the Yin and Yang of the viscera,and dredge the Qi mechanism,so as to achieve the effect of"equilibrium between Yin and yang,spirit is the treatment".With daily care,the clinical effect is better.

Meta-analysis of the effects of inflammatory factors on children with pneumonia mycoplasma pneumonia

Objective:To evaluate the effect of Mycoplasma pneumoniae pneumonia (MPP) on inflammatory factors.Methods:Using the combination of subject terms and free words to search the literature on the effect of children with MPP on inflammatory factors.Retrieved from CNKI, VIP,CBM, Wanfang Database, Pubmed Database, Sciencedirect Database and Google scholor. etc.Time period of retrieval was from database established to May. 2019. 2 researchers conducted literature screening independently according to the inclusion and exclusion criteria. and then processed quality evaluation.RevMan5.3 and stata 14.0 were adopted to conduct Meta analysis on all effective indicators. Results:A total of 23 studies were involved, including 2254 children with MPP and 1182 healthy children. Results of Meta analysis showed IL-6 level(SMD=17.74, 95% CI =15.38~20.09,P<0.0001)、IL-8 level (SMD=19.40,95% CI=18.12~20.69,P<0.0001)、IL-10 level (SMD=9.51,95% CI =8.25~10.97,P<0.0001)、TNF-a level (SMD=31.06,95% CI =24.57~37.54,P<0.0001) were significantly better than the control group, the difference were statistically significant. Subgroup analysis:SMPP compared with MPP, IL-6 level (SMD=12.02, 95% CI =7.08~16.96,P<0.0001)was significantly better than the control group, the difference were statistically significant;Compared with the recovery period, the acute phase of children with MPP, IL-6 level (SMD=20.53, 95% CI =17.51~23.56,P<0.0001)、IL-8 level (SMD=17.27,95% CI=10.14~24.40,P<0.0001)、IL-10 level (SMD=6.04,95% CI =1.72~10.36,P<0.0001)、TNF-a level (SMD=23.64,95% CI =17.60~29.69,P<0.0001) were significantly better than the control group, the difference was statistically significant. Conclusions:MPP caused elevated levels of IL-6, IL-8, IL-10, and TNF-a inflammatory factors in the serum of children, and the levels of inflammatory factors were directly proportional to the severity of the disease.

Clinical treatment of myasthenia gravis with deficiency of spleen and kidney based on combination of disease with syndrome theory

OBJECTIVE: To study the use of Jianjining in the treatment of myasthenia gravis (MG) patients with a deficiency of both spleen and kidney via the theory on the combination of disease with syndrome. METHODS: Sixty MG patients with a deficiency of both spleen and kidney were randomly divided into an treatment group (n=30) treated with Jianjining granules and Western Medicine (prednisone or pyridostigmine bromide) and a control group (n= 30) treated with Jianjining granules. The dosage of the three drugs was reduced over the course of treatment. After 3 and 6 months of treatment, the curative effect was evaluated with the muscle weakness severity scale (MWSS). RESULTS: The MWSS score after treatment declined significantly in both groups. The score in the treatment group was much lower than that in thecontrol group (P<0.05). The total effective rate was 63.33% (19/30) in the treatment group and 36.67% (11/30) in the control group after 3 months of treatment, and 80.00% (24/30) and 50.00% (15/30), respectively, after 6 months of treatment. The obvious and total effective rates in the treatment group were much higher than those in the control group (P<0.05). After 6 months of treatment, there were no obvious differences (P>0.05) in the obvious and effective rates between the 2 groups. However, the total effective rate in the treatment group was much higher than that in the control group (P<0.01). CONCLUSION: Using the theory on the combination of disease with syndrome, we found that the curative effect of Jianjining and Western Medicine on MG patients with deficiency of both spleen and kidney is worth further exploration.